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Thovirs Simsoni, Medicina Trofessoris Candossensis, in Acadcmia Andreana, apud Scotos, dc re Medica, Dissert at ioncs quatnor. In usum Medicines ct llvmanitatis Studiosorum iterum excndi curahat Andreas Duncan, Senior, M. D. fy P. Principis S rot ice Medicus Primarius. His adnectuntur, de Asthmate Infantum . Spasmodico, Dissertatio, auctore Jacobo Simson. De Alvi Purgantium Nat lira ct Usu Dissertatio; et de laudibus Gulielmi Barvei, 0ratio, auctore Andrea Duncan* Edinburgh ISO*), Svo. pp. 327. ?Four Dissertations on Medical Subjects by Thomas Simson, Chandos Professor of Medicine in the University of St. Andrew's. Reprinted by Dr. Duncan, for the Use of the Students at Edinburgh ; to which are subjoined, a Dissertation on the

theories which happened to prevail at the time, so when the theories fell into contempt or neglect, the classes built upon them naturally participated in their fate. The language, however, of valuable original authors on the practice of medicine, would remain un? changed in their works, and consequently the terms founded upoa the prevailing theory at the time they wrote. Thus in every fluctuating science, as medicine or chemistry, many terms will continue in a certain degree of use, long after the public in general have ceased to attempt a defence of their propriety. Such appear to be the terms objected to by Professor S.
The first of these Dissertations is entitled, " An inaugural discourse on the errors of both the ancients and the moderns respecting the materia medica." He sets out with laying down his two principal propositions or axioms. I. <c A practitioner, as such, cares for nothing but the effect of a medicine upon the living human body in various states of disease." 2. " An accurate possession of this knowledge is very difficult to be obtained." By the first he means, that the origin of the metalic or vegetable substance, its natural history, its colour or chemical properties, its manipulation or preparation, are nothing to him as a clinical practitioner.
By the second, he wishes to impress upon his hearers, the great difficulty of acquiring a correct knowledge of the powers of medicines administered internally; and the general fallacy of medical logic.
He next proceeds to establish a third dogma, for, perhaps, this will not be teceived as an axiom by many of our readers; " that nothing ought to be admitted as a medical experiment, the whole and singular of the conditions of which are not clearly laid down ; so that when occasion may require it, any apothecaries' apprentice might repeat it with the same confidence as a natural philosopher, properly educated, can repeat any one of Sir Isaac Newton's experiments on light and colours. For, (he adds) medical practice Ought to be put out of the reach of conjecture; nor, unless in desperate cases, ought any anceps remedium ever to be tried." This extraordinary opinion, if universally adopted, we think would put an end to all improvement in the practice of physic; for every new remedy is necessarily an anceps remedium. A little farther on, (? 12,) he appears to us to invalidate his own dogma, for he says, very properly in our opinion, " All the world will readily confess, that the first origin of any materia medica, as well as that of the whole science of medicine, is enveloped in the greatest obscurity;" for the human mind could never have had any clue to guide it into a comparison of disease with natural productions, as the means of counteracting its fatal tendency. Hence it must follow, that the first hint of the utility of any new remedy must have been derived from accident, or from the analogy of other similar means of cure: in either case, the new remedy must long have continued an anceps remedium.
( No. 137. ) F ?virtues of medicines by our senses. On the discovery of the circulation of the blood, the mathematical physicians conceived that the materia medica might and ought to be founded on mechanical principles. Momentum, fluid; density, cohesion, &c. became favourite objects of re^arch and calculation. Friend mixed blood drawn from z Vein with various substances, in order to ascertain the effcti ol such substances upon the blood in the human body. Professor S. exposes the futility of such experiments by arguments which no one at this time of day ?will be disposed to controvert. After this general sketch of the history of the materia medica and the sources from which it has flowed, he proceeds to examine it as it now stands in our systematic writers, who have treated expressly on the subject. He blames them all for omitting to give the means they used, to prove that the medicincs do really possess the virtues implied by the title of the class under which they are arranged. We do not see the justice of this censure, for a large portion of all human knowledge, which does not admit of demonstration, must be founded on the mere authority of others. As a specimen of his manner of treating these obsolete classes, we will translate his remarks on cephalics. " It is manifest from the titles of the principal heads or classes under which medicincs are'commonly reduced, as cephalics, hysterics, hepatics, &c. without any history of the disease in which they are to be employed, that such an arrangement can answer no practical purpose.
For who, from these naked titles, can determine the virtues of any medicine ? In our examination of these classes, we shall readily grant what they assume, who have laboured most diligently in explaining them, and admit that by cephalics is merely to be understood, those remedies which directly refer to the brain, and which relieve disorders of the animal spirits. Let this then be the sense in which the term cephalic remedy, no matter which of them,'is used; but to which, or what sort of disease of the head, is any one who reads it, to suppose it ought to be applied ? Will he have no difficulty or hesitation among so many diseases of the brain, such as lethargy, apoplexy, catalepsy, paralysis, epilepsy, tremor, phrenitis, mania, and many others comprehended under, the same title? Let him then, if he pleases, go to the nosologists, and learn how many different species there are of each genus, depending on different causes: and how often, almost the same affections are produced by compression only ; whether that compression depends on inflammation, or extravasated fluid, or plethora, unaccompanied by obstruction: and he will easily discover how absurd it must be, in, cases so various, to rely on any one cathv/icon. But there are besides, Dr. Simson's Essays* <5?
besides, many other affections of the brain, arising from poison, for instance, or opiates, (the nature of whose operation we knovr very little about,) in relieving which, these famous cephalics would not be worth a straw ; while a draught of warm water given in time is often of the greatest utility, if repeated vomiting is produced, (as Wepfer abundantly proves in his elaborate work on water hemlock,) although the warm water does not contain a grain of any aromatic, either of odour or flavour, which all our common cephalics abound in. I do not deny that the cephalics already mentioned, may often in the more simple cases, recruit the languid powers of the body; but a prudent practitioner will not draw an argument from the effects of medicines in simple and trivial cases, to more complicated and serious ones." But to these epithets of medicaments just related, they add others of a different kind, which because they possess more manifest and certain effects, and are placed under more appropriate titles, you may say ought to be retained : such are calefacients, soporifics, dissolvents, incrassants, purgatives, diuretics, &c. since there are diseases in which calefacients are necessary, others where soporifics, dissolvents, purgatives, &c. are of great benefit. But although these are liable to fewer objections, yet there is no small * degree of uncertainly attached to them, since it is obvious that medicines of very different powers are comprehended under the same title, and that some of them are better suited to particular states o? disease than others; so that the right use of any of them must depend entirely on an accurate knowledge of the history of the disease." Near the end of this dissertation, he makes some very proper observations 011 the absurdity of jumbling a great number of simple remedies together in the same prescription, and thinks, Quo simplicius eo melius. This ground, however, has been so often gone over before, that nothing new can be expected.
The discourse concludes with a panegyric on their noble patron the Duke of Chandos.
The second Dissertation is on the natural method of curing diseases employed by the ancients before the discovery of the circulation of the blood by Harvey. Having in his first dissertation demonstrated, what he considers as the miserable state in which the materia medica was in his time; in this second, he proposes a plan for improving it. " I shall endeavour, says he, to demonstrate that great improvement may be made in the cure of diseases, if we begin with a correct knowledge of the use of remedies: but that this knowledge can only proceed from a correct and accurate knowledge of the history of diseases; for from a complete history of a disease there naturally arise certain indications of cure, by means ot which we are led to remedies suitable for that purpose." " I am, continues he, the more confident in this opinion, because X observe the great founder of our science to entertain the same sentiments; a physician, he savs, is sufficiently prepared to cure it " F 2 who knows the disease sufficiently: and Sydenham also, the great modern cultivator of simplicity in practice, says, 71 do not think it nccessary to do more than point out the foundations of his several arguments in support of the muscular and nervous pathology, in opposition to the humoral. This subject, indeed, has been so ably discussed by Hoffman, Cullen, Brown, Beddoes, and Darwin, that we need only to refer to their works. He grounds his arguments, in the first place, on sympathy, which cannot be supposed to depend on the fluids. The instances of sympathy, which he principally lays a stress on, are those arising from an irregular or defective action of the uterus, in chlorosis, and ernansio mensium ; increased action of ihe uterus and its vessels in pregnancy and menorrhagia, which are known to affect the functions of the stomach, the action of the heart, and the secreting glands of the whole body. Hysteria is with reason much dwelt on, as this can have nothing to do with the humoral pathology, and must be referred to the mind or sympathy. The stomach and heart are liable to be affected by passions of the mind so violently, as to have their actions suspended or inverted ; and the former is often sympathetically affected by the diseases of the kidnies, ureters, bladder, or urethra. Spasmodic diseases, as may be expected, are not overlooked, of which no one suspects any derangement of the fluids to be the cause.
The liver and its secretion are laid much stress on by the supporters of the humoral pathology; Dr. Simpson, therefore, enters into this subject at considerable length, and explains the derangements supposed to depend on the vitiated state of the bile, to arise from its quantity, or the obstructions to its excretion ; that diarrhoea, or the opposite state of the bowels, depends on muscular and nervous action, not on the quality of the fluids ; and concludes his dissertation, by referring the effects of emetics, purgatives, ami poisons, to their stimulant action on the solids, not to any change they can possibly produce in the fluids in their primary operation.
The Thesis on Croup, by Dr. James Simpson, printed in 1761, contains nothing interesting to practitioners at present; and the same may be said of the Thesis on the nature and use of purgatives.
Such are the contents of these Latin Essays, written long ago, which Dr. Duncan has judged it proper to re-publish in 1809.
Whether they are re-published on account of the matter they contain, or as a model of style for the imitation of the students, for whose use it is now printed, we leave to those who may read them to determine.  long been esteemed one of the opprobria medicorum must be admitted, and every attempt to investigate its history and to improve its treatment, deserves encouragement; it is upon these grounds, therefore, we presume, the Royal College of Surgeons have bestowed their annual medal fpr this performance.
How far the author has been successful in effecting either one or the other of these objects, or whether he has, in the least degree, added to our previous knowledge of the subject, it is our duty to ascertain, taking it for granted that nothing superior to the present Essay was offered to the notice of the Royal College on this occasion. " The term Cancer," the author informs us, in the first paragraph of his book, is employed " to denote a particular connected train or series of morbid phenomena, occurring in the human body." We can inform the author, that the terms gout, smallpox, fever, and the name of every disease incident to the human tody, are so employed; but surely it becomes necessary to enumerate, at least, some of the phenomena occurring in this particular train, to constitute the definition of any one disease ; and yet, that the author means this paragraph to stand for a definition, we conclude, because we can find no other. In appropriating terms, indeed to the various stages of the disease (whatever it be) he is treating of, he thinks it. requisite to ascertain the extent of signification in which they should be applied to the different stages respectively, and which he does as follow : 75 what the author calls tC the enlargement of the glands from simple irritation." Speaking of cancer of the testicle, the Author says, " the disease begins here as in all other glandular organs, by a partial induration." Now as partial induration may, we conceive, arise in an organ independent of cancerous affection, how shall we distinguish when it is, or is not, cancer ? Here, we think, the author has failed in giving us any diagnostic signs whatever; the same thing may he said of 4t that enlargement which is so frequently seen to arise in scrofulous constitutions." " In every case of this kind, in which there may be a doubt, it will at any rate be proper to examine the state of the lymphatic glands in other parts of the body ; and more particularly in the neck and axilla of the opposite side. The information which may, in this way, be obtained, taken in combination with the general history and appearance of the patient, will materially assist us in ascertaining the nature of the case. The peculiar kind of shooting pain, which is generally attendant on scirrhous structure, may also serve to facilitate the distinction. of lupus. The pain too, in cases of lupus, is never very violent, or acute ; and indeed the disease itself generally admits of being cured in no very great length of time, by means of mild external applications." " The organ of vision is another important part, which is subject to a disease that has received the appellation of cancer." This implies a doubt in the author's mind, whether the disease, the symptoms of which are very briefly described, is really cancer; it differs, he says, from almost every other cancerous affection, in being generally a disease of early life. Several writers have noticed this disease, and Mr. Wardrop has lately given us some excellent observations upon it, under the name of Fungus ha^matodes ; it is also sometimes called soft cancer. It certainly differs essentially from cancer, and should not have been included under that title.
After a chapter on scirrhous structure, in which is nothing very important or new, as it contains little more than Mr. Home's description of the appearances on dissection of cancerous scirrhus, we come to the author's " Theory of Cancer, on which we shall offer a few remarks.
The author declines entering into a formal discussion, respecting the nature and causes of cancer; the principal inquiry to which he wishes to restrict himself is, tafy predisposition to the same disease, is an hypothesis neither supported by facts, nor warranted by analogy; it is also contradictory to what the author had before advanced in his attempt to prove, that cancer is not a mere local disease, from its sometimes attacking different parts of the body at the same time.
'* It cannot be urged, in opposition to this, that such parts may have been equally exposed to be affected bv external or accidental causes ; because these same causes, admitting their agency, would at most, in other constitutions, only have given rise to simple inflammation, and its consequsnccsI If simple inflammation and its consequences only, can be produced from external accidental causes, in other constitutions, how can the hereditary cancerous predisposition ever be acquired from the most violent application of these causes ? Among the predisposing causes of cancer, the author enumerates climate, this disease being much more frequent in cold countries, and proportionally rare in warm ones; we confess, we do not understand the following note, nor comprehend the practical difference between arresting and retarding. " Query, Though a warm climate may not. be sufficient to arrest the progress of the disease, under these circumstances, yet will it not retard it ?" The most important part of a " Practical Essay" is undoubtedly that, which explains the treatment of the disease, and to this we shall now turn our attention.
We were particularly struck with the following paragragh; as It is very extraordinary, however, that a disease depending so generally, according to the author, upon constitutional predisposition, should be altogether uninfluenced by internal remedies. A permanent cure then can only be effected by local applications, which will completely remove the tumour, or by excision ; and the Author does not hesitate to give a decided preference to the latter method ; but we will state his opinion in his own words. " I shall now then proceed briefly to notice those means of cure Yvhich have been made use of in cancerous affections, externally.
" The impractibility of reducing the absolute size of a truly scirrhous tumour, is a circumstance which has already been noticed in a former part of the Essay. All the various applications, therefore, which have been made use of to parts affected with cancer, have been intended to fulfill nearly the same indications of cure; viz. to destroy the living powers of the morbid growth, and to effect its consequent separation from the sound and living parts which lie immediately adjacent. " The question accordingly comes to this issue, whether any of the articles which have been employed for the above purpose, possess a power capable of accomplishing such intentions ? " It would not be right to deny that, under certain circumstances, they may possess such a power; but, if we reflect seriously on the great inconvenience, danger, and uncertainty, which necessarily attend their operation, they will, it is conceived, deservedly appear to be held cheap in the general estimation of th? profession.
&Ir. Johnson's Practical Essay an Cdticcr, from the long continued inflammation with which they are nec'di* sarily attendee!. This inflammation tends very considerably to' hasten the further extension of the disease, through the medium' of the lymphatic vessels ; and so put it, in a little time, altogether beyond the reach of art.
" The only other method by which it has been attempted to effect a permanent cure, consists in the excision of the diseased parts: and, though we have but too often to lament its failure when performed late, yet, even under the most unfavourable cir* cumstances, it would not, I conceive, be difficult to shew its advantages over every other proposed means of relief." The excision being determined upon, a question arises, at what period of the disease should the operation be performed ; the author contends for an early removal, and endeavours to refute Mr.
Pearson's objections to its being indiscriminately had recourse to in the early stages of the disease. Mr. Pearson approves of early extirpation when the whole of the diseased parts can be removed, tut he thinks the chance of success greater when the disease is at a stand and its extent can be ascertained, than when it is in progress, and therefore proposes that early excision should be adopted with some limitations. Here we think the author's work defective, and we wish he had informed us, from his own experience, of the comparative results of the operation performed in various periods and stages of the disease.
The author next describes the manner of performing the operation on the various parts affected with cancer; for this, we must refer our readers to the work itself; having already sufficiently extended our remarks, we shall only mention, that in every case of scirrhous breasts, he recommends the removal of the "whole of the breast, whatever be the extent of the disease. This is, certainly, an effectual method of preventing that individual organ from being again affected ; but as it does not remove the constitutional predisposition, hereditary or acquired, and without which predisposition, the author says, simple inflammation only, not cancer, could have been at first produced, the patient is not at all secured from a recurrence of the disease in some other part. should advise those never to presume to prescribe remedies who have not laid a deeper foundation than can be. acquired from a Conspectus or Compendium, yet, as the precise dose of a medicine, not constantly used by any one, is frequently forgotten, this little Manual affords a ready opportunity of recalling it to memory. Under each article, also, is added, what we think valuable information, the various substances with which that article ought not to be joined in composition ; for we must all have seen absurd blunders sometimes committed in prescriptions even by physicians of some eminence, for want of knowing, or of recollecting, the chemical affinities of the several substances prescribed for medicines.